Objective To summarize the management of cardiopulmonary bypass(CPB) for infants below 10 kilograms with congenital heart diseases.Methods From Jan 2010 to Apr 2011,the clinical datas of 122 infants aged from 1.5 months to 2 years with body weight 3 to 10 kilograms,who underwent open heart surgery under mild or moderate hypothermia CPB were retrospectively analyzed.Results Among all the 122 infants,CPB time was 13 ～ 118 min [(62.69 ± 21.48) min],aortic cross-clamp time was 0 to 86 min [(35.47 ± 19.51) min].All patients were spontaneous resuscitation and successfully weared from the machine,no severe complications associated with CPB occurred,3 infants died (2.46％,3/122) after operation.Conclusion Using membrane oxygenator,circuit tubing and artery filter with less priming,and highflow perfusion during CPB,maintaining hemodynamics stable,holding reasonable hematocrit and colloid osmotic pressure,good myocardial protection and ultrafiltration are the significant elements of the management of CPB in infants with weight less than 10 kilograms.

Samples of skeletal muscle in forearm were taken from 60 sites in each of 10 normal autopsy subjects (male 7, female 3) between 3 and 69 years of age. The distribution and composition of type I and type II fibers in the muscles of the forearm were studied by histochemical method for myofibrillar ATPase. The results showed that the mean percentage of type I fibers ranged between 45% to 59% in the muscles of the forearm. In general, the slow contracting fibers of the forearm muscles were slightly higer than 50%. In the flexors and extensors of the forearm the respective percentage of type I fibers were 49.8% and 55.3%. The slow contraction fibers of the extensors muscle group showed higher proportion of type I fibers than those of the flexor group and the difference is statistically significant (P

This paper introduces an assist system for the blind.It utilizes ultrasonic to measure the distance and speed.Then the distance signal is converted to position of slip block and the speed signal is converted to tone.The main function of this sytem is to assist the blind to determine distance and speed of objects.It is practical,Simple and inexpensive.

Objective To reduce or prevent the incidence of bile duct injury in the laparoscopic cholecystectomy,and reduce the postoperative complications of Bile duct injury in the laparoscopic cholecystectomy by time and exact treatment during the surgical procedure.Methods We retrospectively analyzed the clinical data of 8700 cases of LC, including 12 cases of bile duct injury, from September 1991 to today. The corresponding treatment was used in LC to avoid bile duct injury, when bile duct injury occurred, the injury was recognized and immediately repaired by surgery. Result The mean follow-up period after surgery was 5-10 years,all 12 patients with bile duct injury were cured and discharged. Conclusions We should correctly handle the relationship of various duct and avoid burn or cut duct for reducing incidence of the extrahepatic bile duct injury. Correct treatment can reduce or avoid the incidence of postoperative complications.

Objective To evaluate the effectiveness, safety and feasibility of the application of trans-radial thrombus aspiration in patient with heavy burden of thrombus receiving primary coronary interventional therapy. Methods 56 patients with acute coronary syndrome receiving primary coronary interventional therapy were enrolled and randomized to two groups. 31 patients received therapy of thrombus aspiration by Thrombuster II, while 25 patients received routine coronary interventional therapy. We compared the rate of major adverse cardiac event (MACE) in hospital, left ventricular ejection fraction (LVEF) one week post procedure and left ventricular end diastolic diameter (LVEDD), TIMI frame before and after procedure between two groups. Results The rate of MACE was signiifcantly (P<0.05) lower in patients receiving thrombus aspiration (3.3%) compared with routine PCI group (12.0%). LVEF and the rate of patients with TIMI Ⅲafter procedure were signiifcantly (P < 0.05) higher in patients receiving thrombus aspiration. There’s no significant difference in LVEDD between two groups. Conclusions There lies good safety and feasibility for applying thrombus aspiration combining direct PCI in patient with heavy burden of thrombus.

Objective To investigate the anatomic characteristics of the nasolabial fold and to give an accurate description and definition of it in order to to provide theoretical basis for plastic, cosmetic and maxillofacial surgery. Methods Ten (20 sides) adult fresh bodies with vascular perfusion of formalin fixed after morphological observation under a 10 × magnifying len. Results Nasolabial fold was a border between fat-rich zone and non-fat zone in the midfacial region. The nasolabial fold derived from nasal alar skin point in the transverse portion of nasalis, and ended at the outer skin point of zygomaticus major muscle in the mouth. From the anatomy point of view, the nasolabial fold was divided into three segments: the upper, the middle and the under. The upper segment ( Ⅰ ) was the transverse portion of nasalis, (20. 38± 0. 74) mm in length; the middle section ( Ⅱ ): levator labii superioris,(17.13 ± 0.57) mm in length; the under segment (Ⅲ ): modiolus, (20. 81 ±0. 70) mm in length. The nasolabial fold was a connecting region where seven mimetic muscles inserted into the skin point. Superficial musculoapneurotic system (SMAS) and the nasolabial fold were composed of seven mimetic muscles belonging to the same layer. Conclusions The nasolabial fold is a region where the seven mimetic muscles insert into the skin point for connection, and regardless of age, it is an eternal existence. The nasolabial fold is different from the nasolabial wrinkle formed with facial aging and the nasolabial ridges formed by facial mimetic muscles changes.

Objective To assess the ability of ABCD3-Ⅰ score in evaluating the early risk of cerebral infarction after transient ischemic attack ( TIA ).Methods A total of 107 TIA patients were evaluated according to ABCD2,ABCD3 and ABCD3-Ⅰ criteria.The occurrences of cerebral infarction within 2 days and 7 days were observed.Results The AUCRoc of ABCD2,ABCD3 and ABCD3-Ⅰ were 0.61,0.66 and 0.71 in predicting the risk of cerebral infarction within 2 days,and were 0.62,0.68 and 0.74 in predicting within 7 days,respectively.Among 107 patients with TIA,13 evolved into cerebral infarction within 2 days,accounting for 12.1％,and 24 within 7 days,accounting for 22.4％.According to ABCD3-Ⅰ criteria,17 patients were of low risk scored 0-3 ; 54 patients were of medium risk scored 4-7 ; and 36 patients were of high risk scored 8-13.The different incidence of cerebral infarction after TIA was related to ABCD3-Ⅰ score:the higher the score was,the higher incidence was.Except for age factor,every score item of ABCD3-Ⅰ display obvious influence to the occurrence of cerebral infarction within 2 days and 7 days after TIA (P ＜ 0.05 ).Conclusion ABCD3-Ⅰ criteria could more effectively predict the occurrence of early risk of cerebral infarction after TIA,which could be used in regular clinical practice for assistance in TIA risk stratification and treatment.

Objective:To study the expression characteristics of Dickkopf1 (DKK1) in different time and space during tooth development of the postnatal mice, and to provide the theoretical basis for clarifying the mechanism of Wnt signaling pathway in regulating the tooth development.Methods:The postnatal Kunming mice at days 0.5, 6.5, 12.5, 18.5, 24.5, and 30.5 respectively after birth were selected and divided into various groups by time,three in each group.The mice in each group were sacrificed and the paraffin sections of mandibular bone including the first molar were prepared at the thickness of 5 μm, followed by HE staining and immunohistochemical staining in order to detect the expressions of DKK1 in tooth tissue and periodontal tissue.Results:At 0.5 d after birth, the mandibular first molar tooth germ was in the bell stage.At 6.5 d the enamel development of mandibular first molar was almost completed, and the epithelium root sheath extended to the root direction.At 12.5 d the dentin development of crown was completed, with the root formatted about 1/3. At 18.5 d the root had formatted about 2/3.At 24.5 d the root had reached the full length.At 30.5 d the apical foramen was narrow, and the root development was basically completed.There was no DKK1 expression at 0.5 d, but it expressed in the odontoblasts and predentin at 6.5 d. From days 12.5 to 30.5,the expressions of DKK1 were positive in periodontal ligament, alveolar bone, and cellular cementum as odontoblasts, which were gradually increased with the prolongation of time.However, no expression of DKK1 was detected in the pulp.Conclusion:DKK1 shows regular expressions at different tooth developmental stages after birth, suggesting its potential role in the growth of dentin and periodontal tissues.

BACKGROUND: Thoracolumbar segments (T11-L2) prone to damage due to its special anatomical and biomechanical characteristics. Therefore, fully understanding the shape of pedicle of vertebral arch and finding the visible, constant, and the point of insertion of the pedicle axis is very important to the safety of pedicle screw placement.OBJECTIVE: To measure the surgically relevant parameters of thoracolumbar pedicles between Han and Uygur males using computed tomography (CT) scan to provide some anatomic reference data for pedicle screw fixation.METHODS: The vertebral bodies and pedicles of adult males were scanned (60 cases of Han people and 60 cases of Uygur people) from T10-L3 with CT. The parameters were processed by three-dimensional reconstruction. Transverse pedicle width, pedicle axis length, transverse pedicle angle, and sagittal pedicle angle were measured by using length and angle measurement tool of browser in bone-window CT images. The age and stature information were recorded. All the data above were processed by SPSS 13.0 software.RESULTS AND CONCLUSION: (1) The mean transverse pedicle width of T12 and L1 in Han was bigger than that in the Uygur. (2) The mean transverse pedicle angle of T12 and L2 in Han was bigger than that in the Uygur. (3) The mean pedicle axis length and sagittal pedicle angle of T11 and L1 in Han were bigger than that in the Uygur (P < 0.05). (4) There were some differences among some parameters of the thoracolumbar pedicles between the Han and Uygur people.Data from any study only can be used as a guide for pedicle screw fixation. Preoperative CT evaluation may provide an individualized strategy to reduce the incidence of postoperative complications caused by misplacement.

Objective:To investigate the expression of serum human phosphatidylethanolamine-binding protein 4 (hPEBP4) in patients with multiple myeloma (MM) and its clinical significance.Methods:A total of 59 symptomatic MM patients admitted to West Branch of Beijing Chaoyang Hospital from September 2016 to September 2018 were selected as the research objects. According to the CRAB symptoms [elevated serum calcium (C), kidney injury (R), anemia (A), bone lesions (B)], all patients were divided into 2 groups, including the active group of 44 patients with CRAB symptoms, and the response group of 15 patients who achieved at least partial remission after chemotherapy and symptom relief of CRAB. According to the degree of bone lesions (BL), 30 patients with severe bone-related events were grouped as the severe bone lesions (SBL) group, and 14 patients were grouped as the non-severe bone lesions (NSBL) group. According to the revised international prognostic staging system (R-ISS), patients in the active group were divided into three subgroups: stage Ⅰ, stage Ⅱ, and stage Ⅲ, including 26, 11 and 7 patients, respectively. A total of 15 healthy examination people whose gender and age matched those of the patients were treated as the healthy control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of hPEBP4, tumor necrosis factor ligand superfamily member 14 (LIGHT/TNFSF14) and activin A of patients in different groups. Pearson was used to analyze the relationship of the expressions of multiple factors in the active group. The optimal cut-off value of multiple factors diagnosing MM was determined by using receiver operating characteristic (ROC) curve, and according to the cut-off value, the differences in overall survival (OS) of patients with different stratification were compared.Results:In the active group, the respond group, the healthy control group, the level of hPEBP4 was (1.48±0.64) μg/L, (1.49±0.75) μg/L, (0.31±0.10) μg/L, respectively; the level of LIGHT/TNFSF14 was (169±112) ng/L, (256±132) ng/L, (44±27) ng/L,respectively; the level of activin A was (383±266) ng/L, (223±79) ng/L, (234±85) ng/L, respectively; and the differences were statistically significant (all P<0.05). In the active group, the level of hPEBP4 was (1.06±0.60) μg/L, (1.15±0.50) μg/L, (1.73±0.68) μg/L, respectively in patients with stage R-ISSⅠ, R-ISSⅡ and R-ISS Ⅲ, and the difference was statistically significant ( F=3.287, P=0.032). The level of activin A was (219±55) ng/L, (247±117) ng/L, (450±215) ng/L, respectively among patients in stage R-ISSⅠ, R-ISSⅡ, R-ISS Ⅲ, and the level of activin A in stage R-ISS Ⅲ was higher than that in stage R-ISSⅠand R-ISSⅡ (all P < 0.05). The levels of LIGHT/TNFSF14 and activin A of SBL patients were higher than those of NSBL patients [(174±101) ng/L vs. (98±53) ng/L; (467±238) ng/L vs. (189±71) ng/L, all P < 0.05]. The level of hPEBP4 was positively correlated with the levels of M protein ( r=0.694, P < 0.01) and activin A ( r=0.252, P < 0.01) of IgG patients in the active group. ROC curve analysis showed that the optimal cut-off value of hPEBP4, LIGHT/TNFSF14, activin A diagnosing MM was 1.04 μg/L, 97.0 μg/L, 156.2 ng/L. The median overall survival (OS) time of patients with hPEBP4 >1.04 μg/L and hPEBP4 ≤ 1.04 μg/L was 57 months (95% CI 22-92 months) and not reached, respectively, and the difference was statistically significant ( P < 0.05); while the median OS time of patients with activin A ≥ 156.2 ng/L and activin A < 156.2 ng/L was 61 months (95% CI 24-98 months) and not reached, respectively, and the difference was statistically significant ( P < 0.05). Conclusions:High expression level of hPEBP4 is related with the progression of MM. It is positively related with the level of M protein and negatively with the OS of MM patients. It is suggested that hPEBP4 may be used as an important marker to judge disease progression and tumor burden in MM. LIGHT/TNFSF14 and activin A cooperate with hPEBP4 to participate in the pathological processes of tumor microenvironment of MM.